ICD-10-CM 2026 · Effective October 1, 2025

ICD-10 I32

Billable / Specific CC

Pericarditis in diseases classified elsewhere

I32
Block
0
Synonyms
266
LCDs
18
Payer Policies
1
Linked CPTs

About ICD-10-CM I32

ICD-10-CM code I32 represents Pericarditis in diseases classified elsewhere. This is a billable/specific code in the Circulatory System chapter (block I32). The 2026 edition of ICD-10-CM I32 became effective on October 1, 2025.

Coding Tips for I32

Specialist guidance from the PayerReady Medical Coding Team. Specificity warnings, HCC capture rules, sequencing notes.

Inpatient DRG impact: CC

I32 is designated CC for MS-DRG grouping. On inpatient claims, this code can shift the DRG to the with-CC variant when documented as a present-on-admission secondary diagnosis. Hospital CDI programs flag CC opportunities during chart review. Failure to capture this code may leave 30 to 80 percent of the inpatient stay revenue unrealized.

Type 1 Excludes

Pure excludes, these codes can never be coded together with I32. The conditions are mutually exclusive (e.g., congenital vs acquired forms).

  • pericarditis (in):
  • coxsackie (virus) (B33.23)
  • gonococcal (A54.83)
  • meningococcal (A39.53)
  • rheumatoid (arthritis) (M05.31)
  • syphilitic (A52.06)
  • systemic lupus erythematosus (M32.12)
  • tuberculosis (A18.84)

Coding Notes

Code First

  • underlying disease

Inpatient DRG Impact, CC

codes Pericarditis in diseases classified elsewhere. As a Complication/Comorbidity (CC), this contributes to DRG severity adjustment when documented alongside the principal diagnosis.

Medicare LCD Coverage for I32

Local Coverage Determinations (LCDs) from CMS MACs that list I32 as a covered diagnosis.

266 LCDs

Showing top 10 of 266 total . Click a CPT for full coverage scope.

CMS LCD: Billing and Coding: Frequency of Hemodialysis
Article ID: 55672, Effective: 2022-10-01 00:00:00, 56 covered, 1 non-covered
CPT 90999 →
CMS LCD: Billing and Coding: Frequency of Hemodialysis
Article ID: 56159, Effective: 2026-03-05 00:00:00, 56 covered, 0 non-covered
CPT 90999 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 57306, Effective: 2025-11-06 00:00:00, 1168 covered, 0 non-covered
CPT 93320 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 57306, Effective: 2025-11-06 00:00:00, 1168 covered, 0 non-covered
CPT 76376 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 57306, Effective: 2025-11-06 00:00:00, 1168 covered, 0 non-covered
CPT J0461 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 57306, Effective: 2025-11-06 00:00:00, 1168 covered, 0 non-covered
CPT 93306 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 57306, Effective: 2025-11-06 00:00:00, 1168 covered, 0 non-covered
CPT 93325 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 57306, Effective: 2025-11-06 00:00:00, 1168 covered, 0 non-covered
CPT J2785 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 57306, Effective: 2025-11-06 00:00:00, 1168 covered, 0 non-covered
CPT A9700 →
CMS LCD: Billing and Coding: Transthoracic Echocardiography (TTE)
Article ID: 57306, Effective: 2025-11-06 00:00:00, 1168 covered, 0 non-covered
CPT Q9955 →

Commercial Payer Coverage

Coverage policies from major commercial payers referencing I32.

18 policies

1 Aetna

Color-Flow Doppler Echocardiography and Myocardial Strain Imaging - Medical Clinical Policy Bulletins | Aetna
Policy ID: CPB-0008

1 Cigna

Transthoracic Echocardiography in Adults - (0510)
Policy ID: MM_0510

5 Medicare

Billing and Coding: Cardiac Catheterization and Coronary Angiography
Policy ID: ART-52850
Billing and Coding: Frequency of Hemodialysis
Policy ID: ART-55354
Billing and Coding: Frequency of Hemodialysis
Policy ID: ART-55672
Billing and Coding: Frequency of Hemodialysis
Policy ID: ART-55675
Billing and Coding: Frequency of Hemodialysis
Policy ID: ART-55703

CPT Codes Commonly Billed with I32

Procedures frequently paired with this diagnosis based on PayerReady's Dx↔Px linkage data.

1 linkages
  • 90999 CMS LCD: Billing and Coding: Frequency of Hemodialysis CMS LCD

Convert I32 to ICD-9-CM

Per CMS General Equivalence Mappings (GEMs), useful for legacy data review and historical claim analysis.

ICD-10ICD-9Mapping Flags
I32 4200 10000

Flags format (5 digits): Approximate · No Map · Combination · Scenario · Choice List. Source: CMS 2017 GEMs (final version).

ICD-10 I32, Billing FAQ

Is ICD-10 code I32 billable? +

Yes, I32 is a billable ICD-10-CM code that can appear as a primary or secondary diagnosis on claims.

What codes are Type 1 Excludes for I32? +

Type 1 Excludes (never code together with I32): pericarditis (in):; coxsackie (virus) (B33.23); gonococcal (A54.83)

Is I32 a CC or MCC for inpatient DRG? +

Yes, this code is designated as CC. Documenting as a secondary diagnosis on inpatient claims can shift the DRG to a higher-weighted category.

What CPT codes are commonly billed with I32? +

Procedures frequently paired with I32 include: 90999.

What ICD-9 codes does I32 map to? +

Per CMS GEMs, I32 maps to ICD-9 codes: 4200. Useful for legacy data review and historical claim analysis.

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Reviewed by the PayerReady Medical Coding Team

Verified against the CMS 2026 code set on May 31, 2026.

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